| Sumario: | Purpose:This study further delineates the merits and limitations of the Access Technology Delivery Protocol (ATDP) through its application to two children with severe disabilities.Method:We conducted mixed methods case studies to demonstrate the ATDP with two children with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with custom access technologies.Results:After 16 weeks, one child's switch offered improved response efficiency, high teacher satisfaction and increased participation. The other child's switch resulted in improved satisfaction and switch effectiveness but lower overall efficiency. The latter child was no longer using his switch by the end of the study.Conclusions:These contrasting findings indicate that changes to any contextual factors that may impact the user's switch performance should mandate a reassessment of the access pathway. Secondly, it is important to ensure that individuals who will be responsible for switch training be identified at the outset and engaged throughout the ATDP. Finally, the ATDP should continue to be tested with individuals with severe disabilities to build an evidence base for the delivery of response efficient access solutions.Implications for RehabilitationA data-driven, comprehensive access technology delivery protocol for children with complex communication needs could help to mitigate technology abandonment.Successful adoption of an access technology requires personalized design, training of the technology user, the teaching staff, the caregivers and other communication partners, and integration with functional activities.
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